National Provider Identifier [NPI]: |
1508817065 |
Last Name Of The Provider |
GOLDBERG |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 S WASHINGTON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NAPERVILLE |
Zip Code Of The Provider |
605407430 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
201 |
Number Of Services |
5599 |
Number Of Medicare Beneficiaries |
3499 |
Total Submitted Charge Amount |
1546623 |
Total Medicare Allowed Amount |
187789.22 |
Total Medicare Payment Amount |
142186.97 |
Total Medicare Standardized Payment Amount |
137549.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
201 |
Number Of Medical Services |
5599 |
Number Of Medicare Beneficiaries With Medical Services |
3499 |
Total Medical Submitted Charge Amount |
1546623 |
Total Medical Medicare Allowed Amount |
187789.22 |
Total Medical Medicare Payment Amount |
142186.97 |
Total Medical Medicare Standardized Payment Amount |
137549.53 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
297 |
Number Of Beneficiaries Age 65 to 74 |
1411 |
Number Of Beneficiaries Age 75 to 84 |
1139 |
Number Of Beneficiaries Age Greater 84 |
652 |
Number Of Female Beneficiaries |
2040 |
Number Of Male Beneficiaries |
1459 |
Number Of Non Hispanic White Beneficiaries |
2973 |
Number Of Black or African American Beneficiaries |
192 |
Number Of AsianPacific Islander Beneficiaries |
141 |
Number Of Hispanic Beneficiaries |
143 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
3002 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
497 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7395 |